Under the Employee State Insurance Act 1948 there is no maximum limit for ESIC claim amount for getting medical treatment. If an ESIC member fulfills all the eligibility criteria for a certain medical treatment then he or she will get complete treatment for free of cost. Insured members can check their eligibility for various benefits under the ESIC scheme at ESIC IP portal by using their IP number.
Other than medical benefits in ESIC for remaining benefits there is a certain limit for the claim amount, here are the details.
|ESIC Benefit||Claim Limit|
|For medical benefits||No claim limit|
|Sickness Benefit||70% of wages will be paid to the insured person during the |
certified sickness period, maximum for 91 days in a year.
|Extended Sickness Benefit||Sickness benefit will be extended to 2 years in the case of |
34 malignant and long term diseases and 80% of wages will
be paid to the insured worker.
|Enhanced Sickness Benefit||Full wages will be paid to male and female workers for |
7 days & 14 days respectively during sterilization.
|Temporary Disablement||90% of wages will be paid as long as disablement continues.|
|Permanent Disablement||90% of wages will be paid as monthly payment depending on the |
based on the loss of earning capacity.
|Dependents Benefit||90% of wages as a monthly payment in case of occupational |
|Funeral Expenses||15000 Rs|
|Atal Bimit Vyakti Kalyan Yojana Scheme||25% of daily earnings will be paid to the unemployed insured person for 90 days.|
|Maternity Benefit||100% of wages for 26 weeks.|